A generalized linear mixed models approach for detecting myocardial infarction mortality and morbidity in mazandaran, iran, 2008-2009
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1600, poster, cat: 27 A GENERALIZED LINEAR MIXED MODELS APPROACH FOR DETECTING MYOCARDIAL INFARCTION MORTALITY AND MORBIDITY IN MAZANDARAN, IRAN, 2008-2009 A. Khalilian, E. Ghorbanpour, M. Rahimi Janani Mazandaran Medical Sciences University, Iran Background: Special statistical analysis of 2008–2009 Myocardial Infarction incidence rates in the population of the north state of Iran, Mazandaran, was undertaken to identify factors that might explain very strong heterogeneity in the rates. Methods: In this paper, the authors describe a method of adjusting the regression analysis results for strong spatial correlation in the rates by using generalized linear mixed models (GLMM) and the authors propose a general approach to evaluating whether observed counts in relatively small areas are larger than would be expected on the basis of a history of naturally occurring disease. This approach is illustrated using data from the center of statistics hygienic adjutancy of Mazandaran University of Medical Sciences. Results: The results of the specially adjusted, multiple regression analysis showed that MI incidence was significantly positively associated with sex, age and die season and was significantly negatively associated with being the urban or rural. The statistical model was used to produce a model of predicted MI incidence in the area, taking into account local variation from the model prediction if this variation was supported by the data. The predictor variables showed that differences in age or sex can have very marked effects on the heart and vascular disease, even in areas subject to MI control for many years. Conclusions: The results of this study have important implications for MI control programs and determination the high and low risk zones in the area. |